'No sugar', 'no junk food', 'do more exercise' - moving beyond simple messages to improve the health of Aboriginal women with Hyperglycaemia in Pregnancy in the Northern Territory - A phenomenological study.


Journal

Women and birth : journal of the Australian College of Midwives
ISSN: 1878-1799
Titre abrégé: Women Birth
Pays: Netherlands
ID NLM: 101266131

Informations de publication

Date de publication:
Nov 2021
Historique:
received: 13 07 2020
revised: 02 10 2020
accepted: 02 10 2020
pubmed: 5 11 2020
medline: 24 11 2021
entrez: 4 11 2020
Statut: ppublish

Résumé

Globally, rates of hyperglycaemia in pregnancy are highest among Indigenous women. The highest prevalence has been documented among Aboriginal women in the Northern Territory of Australia. Despite knowledge of this for over two decades, there has been very limited examination of the specific needs and experiences of Aboriginal women regarding this condition. How do Aboriginal women with hyperglycaemia in pregnancy understand and experience this condition, and how can their care be improved? A phenomenological methodology underpinned semi-structured in-depth interviews with 35 Aboriginal women and seven health professionals across the Northern Territory. Data were inductively analysed. The findings revealed that in general, participants in this study could recite simple health messaging regarding diabetes (e.g. 'no sugar'), but many lacked in-depth knowledge and this affected the management of their condition. Nevertheless, many identified pregnancy as a powerful motivator for change, signalling scope to improve health messaging. Women consistently expressed the need for diabetes education that was culturally appropriate, a clear desire for maternity care that was family-centred, based on respectful relationships with the same care provider, and respected Aboriginal ways of knowing and being. Existing health messaging around hyperglycaemia in pregnancy has limited reach with Aboriginal women in the Northern Territory. Reducing the burden of hyperglycaemia in pregnancy among these women requires a sustained commitment to redesign of maternity and diabetes care to incorporate the cultural and social context of women's lives.

Sections du résumé

BACKGROUND BACKGROUND
Globally, rates of hyperglycaemia in pregnancy are highest among Indigenous women. The highest prevalence has been documented among Aboriginal women in the Northern Territory of Australia. Despite knowledge of this for over two decades, there has been very limited examination of the specific needs and experiences of Aboriginal women regarding this condition.
QUESTION OBJECTIVE
How do Aboriginal women with hyperglycaemia in pregnancy understand and experience this condition, and how can their care be improved?
METHODS METHODS
A phenomenological methodology underpinned semi-structured in-depth interviews with 35 Aboriginal women and seven health professionals across the Northern Territory. Data were inductively analysed.
FINDINGS RESULTS
The findings revealed that in general, participants in this study could recite simple health messaging regarding diabetes (e.g. 'no sugar'), but many lacked in-depth knowledge and this affected the management of their condition. Nevertheless, many identified pregnancy as a powerful motivator for change, signalling scope to improve health messaging. Women consistently expressed the need for diabetes education that was culturally appropriate, a clear desire for maternity care that was family-centred, based on respectful relationships with the same care provider, and respected Aboriginal ways of knowing and being.
CONCLUSION CONCLUSIONS
Existing health messaging around hyperglycaemia in pregnancy has limited reach with Aboriginal women in the Northern Territory. Reducing the burden of hyperglycaemia in pregnancy among these women requires a sustained commitment to redesign of maternity and diabetes care to incorporate the cultural and social context of women's lives.

Identifiants

pubmed: 33144033
pii: S1871-5192(20)30360-7
doi: 10.1016/j.wombi.2020.10.003
pii:
doi:

Substances chimiques

Sugars 0

Types de publication

Journal Article

Langues

eng

Pagination

578-584

Informations de copyright

Copyright © 2021. Published by Elsevier Ltd.

Auteurs

R Kirkham (R)

Menzies School of Health Research, Charles Darwin University, Darwin, Northern Territory, Australia. Electronic address: renae.kirkham@menzies.edu.au.

S King (S)

Menzies School of Health Research, Charles Darwin University, Darwin, Northern Territory, Australia.

S Graham (S)

Menzies School of Health Research, Charles Darwin University, Darwin, Northern Territory, Australia; Indigenous Reference Group, Diabetes across the Lifecourse Northern Australia Partnership, Menzies School of Health Research, Northern Territory, Australia.

J A Boyle (JA)

Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia.

C Whitbread (C)

Endocrine Department, Royal Darwin Hospital, Darwin, Northern Territory, Australia.

T Skinner (T)

La Trobe Rural Health School, Bendigo, Victoria, Australia; Institute of Psychology, University of Copenhagen, Denmark.

A Rumbold (A)

South Australian Health and Medical Research Institute, Adelaide, South Australia.

L Maple-Brown (L)

Menzies School of Health Research, Charles Darwin University, Darwin, Northern Territory, Australia; Endocrine Department, Royal Darwin Hospital, Darwin, Northern Territory, Australia.

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Classifications MeSH